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BACKGROUND: The objective was to evaluate the efficiency of ProTaper Gold (PTG) and Reciproc Blue (RB) NiTi files in obturation material removal from straight root canals assessed by micro-computed tomography. METHODS: Fifty-two anterior human teeth were shaped with a PTG rotary system until F2 (25/.08). Specimens were obturated with a continuous wave of condensation technique. For retreatment, specimens were randomly distributed in two experimental groups: PTG group (F4 file) and RB (R40 file). Micro-CT scans were performed before and after retreatment procedures. The percentage of the remaining obturation material compared to the original volume was calculated, as well as the retreatment time. The presence of separated files was recorded. A descriptive analysis was carried out, and nonparametric tests were employed. RESULTS: The mean percentages of remaining obturation material in the PTG group and the RB group were 4.14 ± 4.30% and 4.18 ± 4.29%, respectively. The mean retreatment times for the PTG and RB groups were 144 ± 51 and 163 ± 88 s, respectively. There were no statistically significant differences, neither in removal efficiency (p > 0.05) nor in retreatment time (p > 0.05), between the two groups. The coronal and middle thirds presented significantly more remaining obturation material than the apical third (p < 0.05). No file separation occurred. CONCLUSIONS: ProTaper Gold and Reciproc Blue present with comparable efficiency in removing the obturation material, with a similar mean retreatment time.
RESUMO
Excessive gingival display is an esthetic concern for patients. It is a condition in which an overexposure of the maxillary gingiva (>3mm) is present during smiling. There are different etiologies of a gummy smile, such as vertical maxillary excess, short and hyperactive upper lip, altered passive eruption, anterior dentoalveolar extrusion, or a combination of these causes. The correct diagnosis of all etiologic factors is imperative for its appropriate management. Many techniques have been used to restore the dentogingival relation for the management of gummy smile. Lip repositioning is a conservative surgical technique used to treat excess gingival display. It is a largely unknown treatment modality. This limits lip elevation on smiling and increases lip fullness. This technique was designed to be shorter, less aggressive and to have fewer postoperative complications compared to orthognathic surgery. In the current case series presents three patients who were successfully managed with lip repositioning. The aim of this article is to describe the lip repositioning technique to decrease gummy smile by a simple surgical procedure. Key words:Lip repositioning, gummy smile, smile harmony.
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Tooth wear is defined as the progressive loss of a tooth's surface due to actions other than those which cause tooth decay or dental trauma. It is a pathological condition with an increasing prevalence among young people. The aim of this article is to describe an alternative treatment modality to rehabilitate the anterior guidance by a minimally invasive interdisciplinary ortho-restorative treatment. Two patients came to the dental clinic for restorative treatment in order to rehabilitate the worn anterior dentition. Clinical analysis showed tooth surface loss located at the incisal edges by attrition due to an inadequate anterior guidance. In both cases the occlusal vertical dimension was reduced. First, following Dahl's principle, resin attachments were placed in the upper canines. These attachments allowed the extrusion of posterior teeth in order to increase the occlusal vertical dimension. Furthermore, anterior teeth were intruded in order to create space for the restorative material. In the second phase, the restorative treatment was completed. Due to the characteristics of the case, feldspathic ceramic veneers were indicated. A diagnostic wax-up was performed to assist the treatment planning and a mock-up was prepared. Then, maxillary incisors were prepared through the mock-up to ensure a minimally invasive technique. Afterwards, silicone impressions were taken. Finally, veneers were cemented with a light-cured cement. In the present case, the functional and aesthetic parameters required by the patients were achieved, thus satisfying their needs. Key words:Tooth wear, anterior guidance, feldspathic veneers, Dahl's principle, minimally invasive.
RESUMO
The treatment of severe tetracycline discoloration is a challenge for the dentist. There are several treatment options and one of the most effective is the use of feldspathic veneers. The aim of this clinical case was to carry out the replacement with conventional feldspathic ceramic veneers on a patient with highly stained teeth (grade IV tetracycline) by a minimally invasive approach. Clinical examination revealed gingival retraction, color change of the veneers, ceramic cracked of 1.1 and 1.3 and incisal wear in lower anterior teeth. The decision was to retreat with feldspathic ceramic veneers from 1.6 to 2.6. Premolars and first molars were included because its dark color intensifies the width buccal corridors. Also, the restoration with veneers from 3.3 to 4.3 was considered. Firstly, the veneers were removed and the color was selected by the Vitapan 3D Master guide (Vita Zahnfabrick, Bad Säckingen, Germany). Mock-up was made to evaluate aesthetic, phonetic and functional parameters. Then, teeth were prepared through the mock-up in order to reduce the minimal amount of dental tissue possible. Opaque dentine mass of microhybrid composite (Esthet-X A2O, Dentsply Sirona, Konstanz, Germany) was placed to mask the most intense stains. The definitive impressions were taken with silicone (Aquasil Ultra XLV, Dentsply Sirona, Konstanz, Germany) were taken to fabricate conventional feldsphatic ceramic veneers (Noritake kisai Co, Ltd. Japan) by the parallel stratification masking technique. For cementing, an opaque cement was selected from the try-in tests (Calibra, Dentsply Sirona, Konstanz, Germany) and the composite was silicatized with an air-abrasion device. A favorable and minimally invasive result was achieved to treat grade IV tetracycline stains, surpassing the patient's aesthetic expectations and functional needs. Key words:Porcelain veneer, tetracycline teeth, minimally invasive, masking, opaque composite.
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Intrusive luxation is a type of recognizable luxation injury represented by a deeper axial displacement of the tooth toward the alveolar bone. Treatment strategies include waiting for the tooth to return to its position, immediate surgical repositioning, and repositioning through dental traction by orthodontic devices. The aim of this case report was to present the management of severe dental trauma and later restoration following IADT. A 20-year-old patient was presented after fainting at home four hours before, resulting in a dento-alveolar trauma. Clinical examinations revealed a traumatic intrusion, in 1.2, 1.1 and 2.1, uncomplicated crown fractures in 1.1 and 2.1 and a complicated crown-root fracture in 2.2. The diagnosis was confirmed with CBCT. Following IADT protocol, the emergency treatment consisted of the surgical repositioning and semi-rigid splinting using orthodontic wire-composite, replacing the buccal bone plate, and postoperative instructions to the patient regarding oral hygiene. After 2 weeks the root canal treated and filled with fiberglass posts in 1.2, 1.1, 2.1 and 2.2. Splint was removed after 4 weeks and the IADT reassessment protocol followed, with revisions at 6-8 weeks, 6 months, a year and annual reviews for 5 years. A year after the treatment, the traumatized teeth were restored with minimally invasive preparations of feldspathic ceramic. Esthetics and function were recorded with a 3-year follow-up period. Key words:Intrusive luxation, dental trauma, crown-root fracture, dento-alveolar trauma, permanent tooth, CBCT.
RESUMO
INTRODUCTION: The aim of this study was to compare the cyclic fatigue resistance of 3 nickel-titanium (NiTi) endodontic instruments from ProTaper, WaveOne (WO), and Twisted Files (TF). METHODS: Cyclic fatigue testing was conducted by operating instruments from ProTaper F2, WO 25 .08, and TF 25 .08. A total of 184 instruments were rotated in 4 curved artificial canals with different angles and radius of curvature. The time and cycles to failure were calculated. The data were compared for differences by using 2-way analysis of variance (P < .05). RESULTS: In general, WO was the most resistant to fatigue failure of the tested instruments, and TF showed a higher number of cycles to failure than ProTaper. CONCLUSIONS: Reciprocating movement of WO showed a longer cyclic fatigue life than conventional rotary movement of TF and ProTaper. The new manufacturing twisting process of TF produced NiTi rotary instruments more resistant to fatigue than ProTaper instruments produced with the traditional NiTi grinding process.
